Tuesday, March 5, 2024

BNC’s annual rankings of the best North Carolina hospitals

Duke University Hospital of Durham and Moses H. Cone Memorial Hospital of Greensboro tied for top honors in this year’s annual ranking of North Carolina’s best hospitals. Even in legendary Duke coach Mike Krzyzewski’s last year, the quality of the Blue Devil basketball program was not a factor. 

Rather, Business North Carolina’s annual list is calculated using more than 25 health care metrics, including information collected by the U.S. Centers for Medicare & Medicaid Services. The report includes patient-satisfaction surveys, as well as infection, readmission and mortality rates for common procedures. Other factors include safety report cards by the Washington, D.C.-based nonprofit The Leapfrog Group, distinction awards from insurer Blue Cross and Blue Shield, and national performance ratings from U.S. News & World Report.

Duke’s largest hospital moved up from second in 2021 and fourth a year earlier. Its affiliate in Durham, Duke Regional Hospital, tied for third, moving up from 13th last year. The former county-owned hospital became a partner with the university system in 1998 and changed its name from Durham Regional Hospital in 2013. 

Meanwhile, Moses H. Cone has been a longtime top performer, ranking sixth last year, second in 2020 and first in 2019. It is the largest hospital owned by Greensboro-based Cone Health.

Several other big North Carolina hospitals moved up sharply this year. UNC Hospitals in Chapel Hill tied for third after ranking 10th in 2021, while WakeMed Health & Hospitals of Raleigh improved to fifth from 15th a year earlier. Among the state’s smaller independent operators, CaroMont Health of Gastonia ranked eighth and CarolinaEast Health System of New Bern was 12th.

The methodology used to create our list tends to favor large institutions, which gain more points based on national awards and performance rankings. Fewer procedures are often performed at smaller hospitals, which eliminates them from some of the categories that are used for our calculations.

Duke University Hospital

Duke University hospital pictureDuke University Hospital placed the final piece of its 11-floor Duke Central Tower — a $265 million project whose 490,000 square feet includes 350 beds — when it welcomed Duke Children’s Hospital in December. It occupies the tower’s first four floors, where larger rooms accommodate patients’ parents for stays that can stretch for months. There also is an in-house pharmacy service, two pediatric catheterization labs, family zones and activity rooms. Oncology, transplant, orthopedic and neuroscience units had already relocated to the tower. Their former rooms will be renovated.

Duke Health’s heart transplant program is among the nation’s top six by volume. Last year, its surgeons implanted a new-generation artificial heart in an adult patient, marking a first in North America. Another groundbreaking case involved the country’s first heart transplant after circulatory death in a pediatric patient. This type of transplant is not new for the hospital, whose surgeons performed the first such procedure involving an adult patient in 2019.

Moses H Cone

Moses H Cone Memorial HospitalMoses H. Cone Memorial Hospital’s parent — 13,000-employee Cone Health — and Norfolk, Va.-based Sentara Healthcare mutually ended a merger deal last year that would have created an $11 billion system. Officials said they could better serve their communities by remaining independent. The deal would have given Sentara a better foothold in North Carolina, where it only owns Albemarle Regional in Elizabeth City.

Mary Jo Cagle became Cone Health’s CEO in June, the first woman and physician to hold the position. She joined the Greensboro-based health-care system in 2011, when she was named chief quality officer, and she most recently served as chief operating officer. Terry Akin, who had been CEO since 2014, had announced he would step down once the merger with Sentara was complete. President Preston Hammock has led Cone hospital’s day-to-day operations since 2019. 

Duke regional Hospital DurhamDuke University Health System’s $102.4 million Behavioral Health Center opened at Duke Regional in April. The center combines services that were offered at Duke University and Duke Regional hospitals. It includes 42 private patient rooms, two secure courtyards, an expanded emergency department with 18 private treatment spaces and 30 outpatient clinic rooms.

For 45 years, the hospital has served Durham, Orange, Person, Granville, Alamance and surrounding counties. It employs more than 3,500 people. President Katie Galbraith has held several responsibilities at Duke since 2001 and has served as Duke Regional’s leader for about eight years.

UNC hospitals

UNC Hospital photoUNC Chapel Hill has received more than $1 billion in research awards for two straight years. UNC Hospitals and its affiliated medical school account for a big chunk of the funding. The sister organization of UNC Rex Healthcare is a national leader in medical innovation. 

Two major construction projects are underway on the Chapel Hill campus: a 172,000-square-foot School of Medicine medical education building, which is expected to open in November, and a 357,000-square-foot surgical tower slated for early 2024. The tower in front of N.C. Memorial Hospital will feature modern surgical spaces and better patient rooms.

UNC Hospitals is an academic medical center and teaching hospital that is part of UNC Health Care, which owns or operates a dozen hospitals in North Carolina. UNC Health had revenue of about $4.4 billion in its 2020 fiscal year. It has among the strongest credit ratings among U.S. hospitals.

UNC REX Healthcare

UNC REX photoThe UNC Health affiliate opened its $170 million hospital in fast-growing Holly Springs in southeastern Wake County in November, adding 50 inpatient beds, operating rooms, seven labor-and-delivery rooms and an emergency department. About 300 people staff it. Meanwhile, its main campus in west Raleigh is adding a $65 million, 144,000-square-foot cancer center in March. It will supplement suburban cancer treatment sites in four other Wake County locations. 

UNC Rex ranks second in market share in Wake County with about 24% of patient revenue, trailing WakeMed Hospitals and Healthcare, according to Fitch Ratings. The unit earned an operating margin of about 7% in the 2021 fiscal year, which is likely to expand to 9% in coming years, the ratings agency estimated.

UNC Rex is the sole hospital in North Carolina, and among only 23 nationally, to receive a top A rating every year since the nonprofit Washington, D.C.-based Leapfrog Group started rating hospitals for patient quality and safety in 2012. 

WakeMed Health and Hospitals

WakeMed photoWakeMed was founded in 1961 and now has a leading 44% market share of its primary Wake County service area, a 2% increase over the past two years, according to the Fitch Ratings credit service. The not-for-profit organization has complexes in southeast Raleigh, Cary and north Raleigh, with a network of more than 400 primary-care and specialty physicians.

Fitch reported that a $60 million addition at the Cary location added 60 beds, bringing its total to 208, when it was completed last year.

WakeMed had operating income of $39.5 million in its 2020 fiscal year, producing an 8.2% margin, according to a Fitch. The organization employs more than 10,000 people.

Atrium Cabarrus

Atrium HealthAtrium Health Cabarrus, the only acute-care hospital in its namesake county, has plans to add a fifth floor and 30 beds to its Cabarrus County Heart and Vascular Tower, which opened in 2019 at a cost of $115 million. The $47 million addition is in response to findings in the 2021 State Medical Facilities report that pointed to Cabarrus’ need for 22 more acute-care beds to meet its growing population. The floor will add those beds and eight from Hayes Family Center, which is on its campus. Construction is expected to start next year and be complete in 2025. 

Other  recent investments include an updated women’s center at the hospital, whose operations are overseen by facility executive Asha Rodriguez and Roy Hawkins Jr., who was named Atrium’s north market president in September. A former hospital CEO in Florida, Hawkins also oversees Atrium’s Stanly and University City hospitals, along with standalone emergency departments in Huntersville, Harrisburg and Kannapolis.

Atrium Health Carolinas

Atrium Health Carolinas Construction is underway for Charlotte’s first four-year medical school, an effort backed by Atrium Health, Wake Forest Baptist Health and Wake Forest University. Wake Forest School of Medicine-Charlotte will be a neighbor to Atrium’s flagship, Carolinas Medical Center, when it opens in 2024. Plans call for about 3,500 students enrolled in more than 100 specialized programs, creating a massive economic impact for the Charlotte region. Atrium and Wake Forest Baptist partnered in a 2020 merger with the combined organization governed by a board led by Atrium officials. 

Atrium expects the school’s graduates to help staff its expansions. It filed three projects with regulators in October, including adding 75 beds at Carolinas Medical Center, 36 in Pineville and 12 at the University hospital in northeast Charlotte. The three projects represent a combined $155 million investment.

Atrium also is building a $53.8 million hospital in Steele Creek in Mecklenburg County that will open in 2024, the same year it plans to open a $154 million, 160,000-square-foot hospital with 30 beds in Cornelius. In February, it opened Atrium Health Union West, a 40-bed, 150,000-square-foot hospital in Stallings. Other projects include standalone emergency departments in the Ballantyne and Mountain Island areas of Mecklenburg County.


Caromont pictureGrowth is the name of Gastonia-based CaroMont Health’s current game, which includes a $90 million critical-care tower at its hometown CaroMont Regional Medical Center. Set to open early next year, its 146,000 square feet is spread across four floors and includes 26 private intensive-care rooms, centralized nursing stations and administrative space.

The tower is part of a $350 million, five-year investment by the health-care system. The biggest project is a $196 million, 66-bed hospital in Belmont scheduled to open next year. It will have an emergency department, operating rooms, labor-and-delivery unit and imaging services. The hospital is being built near Interstate 85 and Belmont Abbey College, which will offer health care courses in partnership with CaroMont. The not-for-profit system also has opened an urgent care site in Belmont and a primary care office in nearby Cramerton. 

Novant Presbyterian Charlotte

Novant Health Presbyterian Medical CenterIn January, UNC School of Medicine welcomed the first nine students to its Charlotte campus, which is based at Novant Health Presbyterian Medical Center. It’s the Chapel Hill-based school’s third branch campus. It has a capacity of 30 third- and fourth-year students, and studies focus on health equity. The effort began in 2020, when Novant, UNC Health and UNC School of Medicine agreed to expand medical-education, research and clinical services. 

Like its peer Atrium Health, Novant is enlarging its Charlotte region footprint to serve a growing population. Construction on the $180 million Ballantyne Medical Center is underway in south Charlotte with an opening likely in 2023. The project includes a 168,000-square-foot, 36-bed hospital and medical office building. Last spring, regulators approved Novant’s $178.6 million Steele Creek Medical Center, which will cover 186,000 square feet and have 32 beds. It’s expected to open in 2025. 

State regulators also recently granted Novant approval to add 35 acute-care beds at New Hanover Regional Medical Center. The Winston-Salem health care system spent about $2 billion to purchase Wilmington’s dominant provider in February 2021. It also is building a $210 million, 66-bed hospital in nearby Scotts Hill that is slated to open in 2024.

These are the top acute-care hospitals in the state with 50 or more beds based on the percentage of patients who would recommend the hospital to others, as of December 2021. The ranking is based on the Hospital Consumer Assessment of Healthcare Providers and Systems, a survey completed by adult hospital patients between 48 hours and six weeks after discharge. 

BCBSNC Proven Winners

The state’s largest health insurer recognizes hospitals for their quality of care in certain specialties, based on criteria including patient safety and results and input from the medical community. The hospitals listed here were designated as blue distinction centers as of early January. 

Tar Heel Hospital Specialties

Hospitals listed here are ranked regionally or nationally by U.S. News & World Report, which assesses performance in various adult specialties and selected lower-acuity procedures that require a reduced level of care. Patient survival is weighted heaviest, while safety, staffing and other factors are also considered.

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